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Welfare Reform on the Web (February 2011): National Health Service - funding

Biggest of the big spenders

A. McKeon

Health Service Journal, Jan. 27th 2011, p. 14-15

The new NHS Commissioning Board will assume responsibility for purchasing specialised services and primary care. It will hold a budget of about 16.1bn, and will spend on a scale never before seen in the UK. It will have financial clout, the pick of commissioning expertise, and the ability to apply good practice from around the country nationally.

Casualty units shut to pay for private finance hospital contracts

A. Gilligan

Daily Telegraph, Jan. 27th 2011, p. 8

Since 2007, more than a fifth of England's acute trusts with active PFI hospitals have closed casualty departments or published proposals to do so. In the same period, only 4% of trusts without PFI hospitals have closed, or proposed the closure of, accident and emergency units. Health campaigners have claimed that there is a clear connection between the inflated costs of PFI contracts and cuts to accident and emergency services.

Chief execs spell out why they support pay increment freeze

C. Santry

Health Service Journal, Jan. 6th 2011, p. 5

Twelve NHS trust chief executives have signed a letter to HSJ supporting NHS Employers' proposal to freeze pay increments for staff on Agenda for Change bands 1-6 for the next two years in return for a guarantee of no compulsory redundancies.

Hospitals face fines for mixed-sex wards

Press Association

The Guardian, Jan. 21st 2011, p. 17

Hospitals will be fined 250 per patient per day for breaking rules on mix-sex accommodation after more than 11,000 breaches in December, the government has announced.

Joint financing in the new NHS: thinking to the future

C. Goldman and J. Carrier

Journal of Integrated Care, vol.18, Dec. 2010, p. 27-34

Most primary care trusts and councils with adult social care responsibilities are engaged in joint financing and wider health and social care partnership arrangements. There are many uncertainties about how joint financing arrangements and wider NHS, social care and well-being partnerships, are likely to operate once GPs take a lead in commissioning. While the new policy framework for the NHS is clearly in favour of health and social care integration, there are a number of questions about how it will work in practice, given the reconfiguration of organisations and roles, and the amendment and introduction of legislation.

Millions paid to GPs to do what they were already doing

R. Smith

Daily Telegraph, Jan. 26th 2011, p. 14

A study was conducted on the impact of the pay for performance scheme introduced as part of the new GP contract in 2004. Family doctors were awarded points for achieving targets aimed at improving care for patients across a range of diseases. A total of 1.8bn was available to GPs in England under the scheme, of which 20% was awarded for achieving five targets related to blood pressure. The research found that the scheme had no impact, largely because doctors were already improving care and achieving the targets. Monitoring of blood pressure did not increase, prescribing of drugs for the condition did not change significantly and there was no change in the rates of strokes or heart attacks.

NHS consultant paid 105,000 overtime

R. Smith

Daily Telegraph, Jan. 14th 2011, p. 2

A BBC freedom of information request has revealed that NHS consultants are being paid up to 105,000 in overtime on top of their 90,000 salary to clear a backlog of patients and treat those about to breach waiting time targets. These figures have been revealed at a time when the NHS is struggling to make 20bn in efficiency savings over the next four years.

NHS market faces closer EU attention

C. Dowler

Health Service Journal, Jan. 20th 2011, p. 10-11

Historically, EU competition law has been held not to apply to the NHS. However, government plans to allow 'any willing provider' to compete for most NHS clinical contracts could expose the health service to challenge under European competition law.

Paper warns reforms mean 1bn gap in 3.5bn local health budget

R. Ramesh

The Guardian, Jan. 31st 2010, p. 8

A commissioning strategy document obtained by The Guardian reveals that family doctors for 1.8 million patients in North-West London were privately told by outgoing managers last week that they will face a 1bn shortfall in funding by 2014. The document, intended for GPs among the first wave of pathfinder consortia with shadow powers to purchase treatment for patients, states that 'this [1bn] funding gap will require significant changes in how we deliver healthcare' - in substance closing down local hospitals, say doctors' leaders.

Policing the change

D. McCausland

NHS Executive, Nov./Dec. 2011, p. 50-51

As the NHS undertakes a series of major structural reforms, there is potential for it to become more vulnerable to fraud. This article explores how the NHS can protect itself through a period of intense change.

Price rivalry 'could raise death rates'

C. Dowler

Health Service Journal, Jan. 6th 2011, p. 9

The 2011 NHS operating framework confirms that hospitals will be allowed to charge rates lower than the national tariff for treatments provided. The move means that hospitals will be able to compete for contracts from commissioners by cutting prices, not just by raising quality. Health economists and unions fear that this will drive down standards and erode working conditions of hospital staff.

Public expenditure

Health Committee

London: TSO, 2010 (House of Commons papers, session 2010/11; HC512)

This report examines the tough settlements imposed on both health and social care, as put in place by the 'Spending Review 2010'. It finds that these settlements will create a highly challenging context for the delivery of services over the next four years. In both cases efficiency gains will need to be made on an unprecedented scale if care levels are to be maintained and the quality of services improved. In this context, the Government is placing understandable emphasis on the 'extra' funding for social care, provided through the Personal Social Services (PSS) grant and through the NHS. However there is concern that the increases in the PSS grant will not be reflected in changes in actual spending on social care. It is also vital that the savings required by the health settlement are made by efficiency gains rather than making cuts. Improving the interaction between health and social care will be critical if the necessary cost savings on both sides are to be realised. It is not enough for the Government to exhort change in this area: there must be a formal policy infrastructure that recognises the importance of achieving a better overall interface between the two sectors.

Surgeons hit out over NHS operations ban

D. Campbell

The Guardian, Jan. 17th 2011, p. 1

John Black, the President of the Royal College of Surgeons of England, has accused NHS Primary Care Trusts (PCTs) of pursuing the dangerous course of refusing treatment to patients who will then suffer unnecessary pain and have less chance to make a full recovery. The NHS in England needs to save 20bn by 2014-15. As part of this efficiency drive, operations for conditions such as hernia, cataract and arthritic joints are increasingly being banned.

(See also The Guardian, Jan. 17th 2011, p. 8)

Unions reject pay freeze offer

C. Santry

Health Service Journal, Jan. 13th 2011, p. 7

NHS Employers had proposed that trusts freeze incremental pay for all staff in return for a guarantee of no compulsory redundancies for those on Agenda for Change bands 1-6. Unions have rejected the offer.

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